Manuski means humanism in Marathi. A term used by Dr B.R.Ambedkar, a great humanist of India. This blog want stimulating debate without any prejudices of caste, religion and nationalism. It is about humanism and human rights. All freethinkers are welcome to contribute and participate in stimulating debates.

Sunday, July 21, 2013

Issue of Medical Ethics in India

By Vidya Bhushan Rawat

It was an invitation that I could not ignore as the subject
was close to my heart and being organized by a premier medical institution in
the capital of India. The issue was ‘medical ethics’ and the main speaker was a
humanist philosopher from Utrecht University in Netherlands. As it was being organized
for the students, who were future doctors emerging out from this premier
institution, my friend suggested that there could be two other speakers who
should express their opinion in the beginning for the benefits of the students.
One was a former alumnus of the institution; a well-known doctor now settled in
US but is contemplating to start working with communities in India and second
was myself who was supposed to give some factual analysis of what happens here
in India.

The other speaker finished in 5 minute time allotted to him
and the host invited me to speak of my experiences so that our main speaker
also has an idea. I started through bullet points and wanted to inform that I do
not generalize but all these things have happened and we face it, though there
are exceptions.

‘Friends, a few days
back three sanitation workers died cleaning the sewage line in the Indira
Gandhi National Centre for Art. The police took their bodies to Ram Manohar
Lohia hospital and all the three were declared brought dead but their details
were mentioned as unknown, unidentified etc. and their families got information
next morning. There is no cooperation with families of the poor.

In Uttar-Pradesh and
Bihar, most of the Primary Health Centers do not have proper facilities and
sweepers and non-medical staff do even perform minor surgeries. You might have
seen latest report of death of a child in Balia on the NDTV. I want to tell you
why this happen. It reflects the class-caste bias among our medical fraternity.
Since the upper caste-class in the villages or rural India prefer to private
hospitals, it is the rural poor who go to these PHCs and hence we don’t want to
touch them. It is this prejudices that we carry on further that result in
unwanted deaths.

In Delhi, I am amazed
to see the small temples outside the ICUs of many prestigious hospitals where
people go and break coconut before entering the ICU. Is that ethical? Should we
allow such thing inside the hospitals? Does it not violate the spirit of
inquiry and scientific temperament?

My own experience at a
hospital was that doctors don’t really appreciate when you want to donate
organs and body after death.

The emergency wards of most
of hospitals are horrible. I have gone through personal experiences when in a
place like AIIMS, we had to wait since morning and finally the patient could
only be admitted in the evening at 9 pm.

The doctors and nurses
speak with their patient in most rustic way and forget that patient too deserve
respect from the doctors and their staff. In the big hospitals, doctors do not
inform the patients or their wards about the ailment and most shocking are the
event when due to lack of money hospitals refused to give away the dead body.

Gynecologists normally
discourage women for family planning if they have daughters.

Today, many of the
psychiatrists in Delhi are promoting the ‘Gayatri Mantra’ to get rid of
tension. What will they advise to Muslims, Christians or atheists to get rid of
depression?

And finally, dear
friends, the biggest ethics is to treat each patient without discriminating on
the basis of their identity. You must have heard Praveen Togadia. Some people say,
he was a doctor…’ (I am not allowed to
complete my statement by a teacher who gets up and snatch microphone from my
hand)

Suddenly, there is unease in the heart of some one. The
participants are listening but the man at the end row gets up shouting,’ why
have we been invited to ‘waste’ our time here? It is an ‘academic’ seminar and
we cannot allow ‘anyone’ to speak here’. I am taken aback but keep my calm. The
students and audience are stunned. The man comes and snatches the microphone
from my hand. He does not allow me to speak. He just asks me to go. I don’t know
how to react as every institution has a hierarchy. I give in and silently go
and sit on my seat. I don’t retaliate as I feel the people who have invited me
should have done or may have their problems. The ‘professor’ now takes
charge. He starts condemning me and
countering everything that I spoke. He justifies statues of gods and goddesses
inside the hospitals suggested there was nothing wrong with Gayatri Mantra to
give ‘strength’ to patient. Everybody is just shocked. Anyway, I decide not to
walk out as I was not a designated speaker but only requested to speak. I want
to listen to the guest from Netherlands and hence decide to not to make a fuss
of it but as I don’t know the internal politics inside the institution which is
very natural in all these big institutions.

Our friend from Netherlands speaks and explain beautiful what
medical ethics is and the issue he focuses on is that we have to go beyond just being ‘doctor’ in
technical sense. We have to respect scientific temperament and have humanist
values. He spoke about prejudices of different kinds in our societies
everywhere and how and why the doctors should keep away from it. We cannot be
seen supporting alternative medical methods. We have to support all that which
come through scientific inventions after years of hard work. Of-course, he
raises the issues of prejudices against untouchables and disabled people. In
many countries, there is a clear war against homo sexual and therefore he
suggest that the doctors cannot go according to the prevailing notions of
society but according to what science is and what medical research speak about.

After the lecture is over the students are silent but the organizers
tried to have some questions answer session but not everyone is ready after all
this. A girl stood up and asked how to deal with homo sexuality issue in India
where society still treats it as taboo. And again this philosopher friend speak
with same conviction that according to all report, there is nothing wrong about
homo sexuality and it is the decision of two individuals to decide how should
they live. We cannot criminalize homo sexuality and their country was the first
one to allow the gay marriages too.

Feeling much uncomfortable again, this ‘professor’ again gets
up to argue against that. ‘I have no problem with homo sexuality but it cannot
be termed as normal behavior as there are no studies suggesting that. We live
in a society which does not respect it. How can we justify gay marriages?’

The hall is silence and none want to respond to him. The silence
has said so many things. The students in these institutions live under
tremendous pressure and hence try not to offend their faculties. Secondly,
these institutions still have people who are actually a shame to the name of
teaching profession. It is also true that all kind of elements have entered
into the medical profession who join it to earn money and in that humanity
becomes the biggest victim of their deeds. The fact that we still feel sympathetic
to the likes of Praveen Togadia and Maya Kodnani, shows that we still carry our
caste and religious prejudices along with us and medical ethics don’t work for
us. I am happy that most of the teachers that I spoke afterwards agreed with my
view point though they disagreed direct ‘naming’ of an individual though I felt
they should have stood up and objected but I also know that these institutions
are always suffer from inter departmental politics and games are played to
disturb the programme and hence I did not fall prey to their politics and kept
quiet.

The profession of a doctor is noble one. They were considered
as God. Their soft voice worked like balm on the patient. I never generalize the
issue but the trend is visible. And when we were discussing things at the
college, it means we are friends of society, after all, those who invited me to
their institutions have been aware of my writings and my work for long. Even if
they have not known my work, what were the things which violated the basic
ethics? Did I speak anything which violate the basic decency but what I realize
very fast was that once I uttered Togadia, the professor could actually visualize
as what was coming next and being a sympathizer or a member of the organization,
he could not allow such things to go but these fellows do not know that they
can stop me from their institution but not from general public.

It is shameful that academic institutions where the freedom
of expression and dissent should be honored are becoming highly intolerant to
criticism. Each philosophy and ideology failed here because the caste and
religious prejudices. The arrogance of being ‘powerful’ and ‘twice born’ still
exist in our society. Medical profession has grown tremendously and money has
become the major criteria yet with in this age of market and money, modernity
has become the biggest victim. Medical ethics transcends nationality, caste,
religious and all kind of boundaries and that is why doctors have been respected
world over as their only respect is meant for humanity and trying to save a
human life irrespective of his faith and political ideologies which actually
look dim in India where our prejudices are superseding them. It is time the
institutions start a cleanup operation so that our doctors are not just
respected for their knowledge but also for their human values and medical
ethics too. Our academic institutions can only do it once they shed their caste
prejudices and allow wider diversity in these places of learning so that India
as a whole grow and people here particularly those who are poor and not among ‘them’,
do not suffer out of these prejudices.

Followers

About Me

Learning through working. Working at the grassroots made me realise the big difference between those who claim to represent communities as well as the communities themselves. Common man is crushed between the ambitions of various individuals to lead and dominate. The dominant and high numbered communities will always dominate our discourse and the most marginalised are losing in this entire discourse. That is the reason why Mushahar remain at the marginalised and the issue of manual scavenging still not on our top agenda and to eliminate that the community has to decide its own organisations..

I am devoted to freedom of ideas and expression. I personally feel that we in the subcontinent want to dominate and control our discourse and each one of is a ultra nationalist in terms of their caste and community. Nationalism is not just national and political but it is equally in term of religion and caste. I feel each kind of nationalism is a dominant discourse which deny the dissenter a right to speak.

At the end, we all want to listen the truth suitable to us.. we have become expertised in the art of speaking truth of convenience. As long as that remain hall mark of our society and we speak to already converts, this society will remain stagnant, it will always try to control our ideas and choices. We need to oppose any such perception, ideas that want to control our mind and victimise us.

To understand India further, I feel, it is good to do foot walk, ( Padyatras) to various parts of the country. I have so far done it thrice covering nearly 1500-2000 kilometers. It is always interesting to see how people are coping their issues and what is the reason of their exploitation.